Platelet-Rich Plasma for Musculoskeletal Disorders: No Infection Reported in Daily Practice

Abstract

Background: Platelet-rich plasma is an autologous blood product defined by a concentration of platelets higher than baseline. Enough evidence supports its application for the treatment of orthopedic disorders. Objectives: The aim of this study was to report the absence of infection and/or complication events related to platelet-rich plasma treatment in patients with musculoskeletal disorders of diverse etiologies. Methods: This transversal and descriptive study included a total of 513 patients, presenting either common orthopedic disorders or hemophilic synovitis/arthropathy. Peripheral whole blood was collected in the presence of anticoagulant and centrifuged. Platelet-rich fraction was separated under sterile conditions. Before injection, the affected area was sanitized and covered with sterile field drapes. Injections were performed in the procedure room under ultrasound image. No anesthesia or antibiotics were administered. Data were analyzed using Pearson’s chi-square test and Cramer’s V test. Results: Of the 923 procedures, 63.2% were intra-articular, and 36.8% were performed in soft tissues. Intra-articular injections were more common in patients with hemophilia, compared with patients without hemophilia (P < 0.001). The most commonly affected anatomical sites were: the knee, the ankle, the hip, and the elbow, with a higher prevalence of ankle and elbow disorders in patients with hemophilia, compared with patients without hemophilia (P < 0.001). Among patients with hemophilia, 13 presented HCV infection, one presented HIV infection, and three were coinfected with HCV and HIV. Twelve patients presented inhibitors. No complications were observed during blood extraction or after platelet-rich plasma injection. No infections occurred at the site of injection. Conclusions: Our platelet-rich plasma preparation and administration protocol under sterile conditions considerably reduce the chances of contamination and further complications associated with it. The occurrence of infection after intra-articular or soft tissue injection was nil in this study, even in patients with hemophilia.